Editorial
Trauma, posttraumatic stress disorder symptom clusters, and physical health symptoms in postabused women

https://doi.org/10.1053/j.apnu.2003.11.005Get rights and content

Abstract

The purpose of this retrospective, descriptive-correlational research was to examine the relationships between violent and nonviolent trauma, posttraumatic stress disorder (PTSD) and its symptom clusters of avoidance, intrusive/re-experiencing, and hyperarousal, and self-reported physical health symptoms in 50 postabused women. Results indicated: (1) PTSD hyperarousal and avoidance symptom clusters were positively associated with physical health symptoms, and (2) childhood physical abuse accounted for a significant and unique portion of the variance in physical health symptoms. The results highlight the need for health care practitioners in all settings to assess for a history of trauma in a woman’s life.

Section snippets

Review of literature

Research has shown that intimately abused women experience serious physical health problems requiring medical, trauma, or gynecologic treatment Campbell and Alford 1989, Follingstad et al 1991, Golding et al 1997, Tollestrup et al 1999, and psychological/emotional health problems, including depression Campbell 1989, Dienemann et al 2000, Jack and Dill 1992, substance abuse Curry 1998, McFarlane et al 1996, and PTSD Astin et al 1995, Houskamp and Foy 1991, Kemp et al 1995, Saunders 1994, Woods

Method

A retrospective, predictive-correlational design was used to examine the relationship between lifetime trauma, PTSD symptom clusters, and physical health symptoms in postabused women. A convenience sample of 50 postabused women, who had been out of a battering relationship at least 1 year, were recruited through bulletin board postings and pamphlets in community agencies, libraries, supermarkets, YWCAs, and churches. After obtaining consent, the women completed a questionnaire booklet

Physical health problems in PTSD-positive postabused women

The mean SCL-PTSD score for the study sample was 1.25 (SD = .95) and ranged from .04–3.43 on a scale of 4. Saunders et al. (1990) identified that a clinical score of 0.89 or above on the SCL-PTSD maximized the scale’s ability to discriminate the presence of PTSD. Based on this cut-off score, 52% of the postabused women met criteria for PTSD.

The differences between the postabused women who were PTSD positive and PTSD negative and physical health symptoms were analyzed using the phi coefficient,

Discussion

The results of this study demonstrate that violent trauma throughout the lifespan impacted the health of postabused women. In this sample 52% of the postabused women met criteria for the diagnosis of PTSD. These women had experienced many lifetime violent and nonviolent traumas accounting for 24% of the variance in physical health symptoms. But only violent trauma throughout the lifetime significantly influenced the long-term health of postabused women. The postabused women experienced multiple

Conclusions

The prevalence of lifetime violent trauma in women and its short- and long-term sequelae on health are great. The results highlight the need for health care practitioners in all settings to assess for a history of trauma in a woman’s life, particularly when a woman presents with multiple nonspecific physical health complaints. In addition, practitioners need to consider a relationship between nonspecific health complaints and PTSD avoidance and hyperarousal symptom clusters.

Further research is

References (47)

  • J.D. Bremner et al.

    Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans

    American Journal of Psychiatry

    (1993)
  • N. Burns et al.

    The practice of nursing research

    (1997)
  • D.W. Campbell et al.

    The reliability and factor structure of the Index of Spouse Abuse with African-American battered women

    Violence and Victims

    (1994)
  • J.C. Campbell

    A test of two explanatory models of women’s responses to battering

    Nursing Research

    (1989)
  • J.C. Campbell et al.

    The dark consequences of marital rape

    American Journal of Nursing

    (1989)
  • J.C. Campbell et al.

    Women’s responses to batteringA test of the model

    Research in Nursing & Health

    (1999)
  • J.C. Campbell et al.

    Forced sex and intimate partner violenceEffects on women’s risk and women’s health

    Violence Against Women

    (1999)
  • J.C. Campbell et al.

    Reproductive health consequences of intimate partner violenceA nursing research review

    Clinical Nursing Research

    (2000)
  • G.P. Chrousos et al.

    The concepts of stress and stress system disordersOverview of physical and behavioral homeostasis

    JAMA

    (1992)
  • J. Dienemann et al.

    Intimate partner abuse among women diagnosed with depression

    Issues in Mental Health Nursing

    (2000)
  • K. Eby et al.

    Health effects of experiences of sexual violence for women with abusive partners

    Health Care for Women International

    (1995)
  • D.R. Follingstad et al.

    Factors moderating physical and psychological symptoms of battered women

    Journal of Family Violence

    (1991)
  • M.R. Fullilove et al.

    Violence, trauma, and posttraumatic stress disorder among women drug users

    Journal of Traumatic Stress

    (1993)
  • Cited by (42)

    • The traumatized body: Long-term PTSD and its implications for the orientation towards bodily signals

      2018, Psychiatry Research
      Citation Excerpt :

      Yet, findings regarding the divergent implications of PTSD symptom clusters for the experience of the body are inconsistent. Specifically, while some findings suggest that all clusters are associated with reported somatic symptoms (Hoge et al., 2007), others found avoidance symptoms to explain health service utilization (Polusny et al., 2008), and physical health symptoms (Woods and Wineman, 2004). A few studies, however, found that alongside other clusters, hyperarousal symptoms are correlated with physical functioning (Tsai et al., 2015) and physical health symptoms (Woods and Wineman, 2004).

    • Biological and clinical framework for posttraumatic stress disorder

      2012, Handbook of Clinical Neurology
      Citation Excerpt :

      PTSD status has a stronger association with these specific physical health problems than anxiety or depression (Boscarino, 1997; Andreski et al., 1998; Weisberg et al., 2002), and, where a nontraumatized control group is included, PTSD is a stronger predictor of physical health in multiple categories than trauma alone (Weisberg et al., 2002). Physical health problems also correlate with the intensity of hyperarousal and avoidance symptoms (Woods and Wineman, 2004). A number of studies of individuals experiencing danger and/or life threat have shown specific peritraumatic dissociative changes, including alterations in time sense, perception, attentional focus, and awareness of pain, among others (Morgan et al., 2001).

    • Physical Health and Posttraumatic Stress Disorder Symptoms in Women Experiencing Intimate Partner Violence

      2008, Journal of Midwifery and Women's Health
      Citation Excerpt :

      However, the relationship between physical health and PTSD symptoms in women experiencing IPV was not examined in these studies. This issue is important because PTSD may be both an acute and long-term effect of IPV,6,12–14 lasting even after the woman has left the abusive relationship.7 Golding5 conducted a meta-analysis of 11 studies and reported that 31% to 84.4% of women who experienced IPV met PTSD criteria (weighted mean prevalence = 63.8%).

    View all citing articles on Scopus

    Supported by The University of Akron Summer Research Fellowship, Akron, OH.

    View full text